A test of the Self-Help Model: learned response to chronic illness experience.

The purpose of this study was to increase understanding of the essential dynamics of learned response to chronic illness experience. A Self-Help Model was tested with 396 subjects with diagnoses of rheumatoid arthritis or arthritis-related conditions. Self-Help Model variables include disease characteristics, background inputs, monitoring, severity of illness, dependency, uncertainty, enabling skill, self-help, and life quality. Severity of illness, disease characteristics, background inputs, and monitoring explained 24% of the variance in dependency and 40% of the variance in uncertainty. Monitoring was the strongest contributor to explanation of enabling skill; however, only a small amount of the variance in enabling skill was explained, adjusted R2 = .15. Enabling skill was the strongest predictor of self-help, beta = .42, minimizing the influence of uncertainty, beta = -.23 and dependency, beta = -.10, on self-help, R2 = .55. Self-help was strongly related to life quality, beta = .62. Self-help and uncertainty explained 49% of the variance in life quality. Results suggest a basis for interventions that reduce dependency and uncertainty and enhance enabling skill.